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The "Special K" you don't want your kids to eat

Urologists around the world see young patients suffer severe bladder problems after using ketamine.

A woman walks past the display introducing commonly abused drugs at the Drug Info Centre in Hong Kong in June 2007. (Paul Yeung/Reuters)

LONDON — In September 2006, Peggy Sau-Kwan Chu, a urologist at Tuen Mun Hospital in Hong Kong, saw a patient in his 30s complaining of severe bladder problems. His symptoms included painful urination, incontinence and urinating every 15 minutes. He mentioned to her in passing that he had been using ketamine for the last 10 years.

Two months later a married couple — he 25, she 22 — came with similar symptoms. Chu, suspecting environmental factors, asked if they had grown up near each other, but the couple had not. Nor were they cousins, which ruled out any genetic link. They had, however, both been using ketamine for a protracted amount of time.

Chu, on the hunch that ketamine (a drug whose nicknames include K, Special K and raver’s smack) was causing these severe problems, talked to other Hong Kong urologists and found they were seeing similar cystitis-like symptoms in young patients. Working through a rehab clinic, Chu sent a survey to 97 former ketamine users asking if they had suffered the same issues — 30 percent admitted they did.

“That was when I realized that there was something seriously wrong,” said Chu, who last month presented a paper on the subject to the American Urological Association meeting in Chicago.

What Chu discovered was that heavy and frequent ketamine use inflames the bladder, shrivels the organ and eats away at its muscle, so that the bladder has trouble contracting. Almost as soon as Chu and her colleagues published their findings they said, urologists across the globe contacted them to say they were witnessing the same symptoms.

The use of ketamine — and the health problems it causes — is on the rise around the globe. In 2001 only two countries reported seizures of ketamine — which can be snorted, injected or digested — while that number had jumped to 20 by 2006, in countries from Argentina to Australia to Canada. Use in Asia is particularly widespread and there have been multi-ton seizures in China, Hong Kong and Taiwan.

“K is really taking off in some parts of the world and potentially in others but we just don’t know,” said Jeremy Douglas from the United Nations Office on Drugs and Crime (UNODC). “We need to pay attention to it and we really have to start tracking better information on the drug.”

Ketamine is fairly easily trafficked because in countries like India it can be purchased over the counter — it is used as a horse tranquilizer and in some developing countries it is used in surgery because it is comparatively cheaper than other anesthetics. It can be transported across borders in liquid form with little trouble, because it is odorless and colorless. There have been cases where traffickers have shipped liquid ketamine into a country claiming it was rosewater or massage oils.

There has been enough international concern about ketamine (along with other synthetic drugs) that last year the UNODC launched the Synthetics Monitoring: Analysis, Reporting and Trends (SMART) program to help governments track and screen information on these drugs.